Kidney damage due to systemic lupus erythematosus

Nhung, 25 years old, had persistent leg swelling and gained 5 kg in a short period of time. The doctor discovered that systemic lupus erythematosus caused glomerular damage.

Doctor Nguyen Thi Minh Anh, Department of Nephrology – Dialysis, Tam Anh General Hospital in Hanoi, said Nhung has nephrotic syndrome with a condition of losing a lot of protein through urine. The patient also had a butterfly rash on the face. Some immunological tests showed positive results such as antinuclear antibodies (ANA), anti-Sm antibodies, RNP/Sm antibodies and reduced complement C3 (an immune system protein that is often reduced when lupus is active). From these signs, doctor Minh Anh diagnosed Nhung with systemic lupus erythematosus with kidney damage.

Systemic lupus erythematosus is a chronic autoimmune disease that causes the immune system to mistakenly attack many organs in the body such as the skin, joints, heart, lungs, nervous system and especially the kidneys. Among them, kidney damage is a serious complication when prolonged inflammation reduces the filtering function of the glomerulus.

Nhung’s histopathological biopsy results recorded damage to the glomerulus – the unit responsible for filtering blood of the kidney, and also detected the deposition of many types of antibodies and complement, which are characteristic signs of lupus nephritis. These lesions reduce the kidney’s ability to retain protein, causing protein to be lost through urine and causing nephrotic syndrome with prolonged edema in the patient.

Patients are treated with an immunosuppressive regimen combined with corticosteroids to control the inflammatory response and limit progressive damage to the kidneys. Doctors regularly monitor kidney function, urine protein levels and immune indicators to evaluate treatment response.

After 4 weeks, Nhung’s edema was gone and her weight gradually stabilized. Tests showed a significant decrease in proteinuria, maintained kidney function and no signs of decline in glomerular filtration rate. After the active treatment period to control the immune response, patients are transferred to a maintenance regimen and periodically monitored on an outpatient basis to control the risk of relapse as well as evaluate long-term response.

According to Dr. Minh Anh, lupus nephritis is one of the most common lesions of systemic lupus erythematosus. The patient may only have edema or proteinuria, but internally, the kidney’s filtering structures have been damaged by the immune response. If not detected early and treated properly, prolonged inflammation can impair kidney function, progressing to chronic kidney disease or kidney failure, requiring the patient to undergo dialysis or a kidney transplant to maintain life.

When signs such as leg swelling, face swelling, foamy urine, unusual weight gain, or a prolonged skin rash of unknown cause appear, the patient should see a doctor early to detect the disease in its early stages, treat it effectively, and limit the risk of irreversible kidney damage.